Disadvantages
The addition of any type of Invisalign to a Litchfield Park orthodontic treatment plan has four main disadvantages: cost increase, bone availability problems, access problems and treatment time is longer. It has long been advocated by Litchfield Park orthodontists to wait three to four months for full osseointegration before loading an Invisalign. The Branemark study found long term stability is achieved with a proper surgical technique and Invisaligns remain without loading for 3-4 months in the mandible and 5-6 months in the maxilla. Many Litchfield Park interdisciplinary teams also advocate 10-12 weeks of healing before loading Invisalign specifically for Litchfield Park orthodontic anchorage. Any attempt to decrease the waiting time by increasing the amount of bone to the Invisalign surface would be valuable to the patient and Litchfield Park orthodontist.
Immediate Loading
There have been multiple Litchfield Park orthodontic studies investigating the idea of loading Invisalign without waiting any prescribed amount of time. Early Litchfield Park orthodontic studies in the orthopedic and dental literature confirmed the idea that early loading leads to fibrous encapsulation and subsequent Invisalign failure. One Litchfield Park orthodontic study comparing loaded versus unloaded Invisalign in dogs showed normal osseointegration in controls and fibrous encapsulation on the loaded fixtures.
More recent research has shown success in the area of immediate loading. Many of these Litchfield Park orthodontic studies restored the fixtures with a provisional restoration incorporating multiple Invisaligns. Some utilized edentulous patients where the Invisalign was restored with an overdenture incorporating all fixtures. This provides a splinting mechanism, decreasing the load for an individual Invisalign. Some work by Litchfield Park orthodontists has been done on single tooth loading with some encouraging results, but the investigators continue to warn against “excessive” loading and emphasize that proper patient selection is a key to success.
Regeneration of Bone
Very often, Invisalign is placed by Litchfield Park orthodontists soon after a tooth has been extracted. The extraction site healing process is complicated and quite lengthy. A blood clot forms within 24 hours and by one week, bony remodeling is already taking place. At three weeks, it is noted by Litchfield Park orthodontists that the extraction socket is filled with dense connective tissue, but remodeling has resorbed approximately 50% of the original alveolar bone height. By two months, the bone formation in the socket is complete, but it does not reach the original height resulting in less bone for Invisalign placement.
There is a marked difference between regeneration and repair by Litchfield Park orthodontists. Regeneration results in the tissue returning to its original form and function while repair does not produce the original form and may contain large quantities of scar tissue. In a case where there will be subsequent Invisalign placement, Litchfield Park orthodontists prefer complete regeneration of the alveolar process. More traditional techniques to assist in regeneration before and during Invisalign placement include bone grafts and guided bone regeneration. There have been new advances in the field of tissue engineering by Litchfield Park orthodontists in which there is an attempt to regenerate tissues in the body using the addition of biologic mediators and matrices which mimic the tissues original formation processes.
Litchfield Park Office
5220 N. Dysart Rd #150
Litchfield Park, AZ 85340
TEL: 623.536.4939
FAX: 623.536.4877
Phoenix Office
7550 N. 19th Ave #101
Phoenix, AZ 85021
TEL: 602.864.0004
FAX: 602.864.0070
